There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in ...increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream.
Baer's review (2003; this issue) suggests that mindf ulness‐based interventions are clinically efficacious, but that better designed studies are now needed to substantiate the field and place it on a ...firm foundation for future growth. Her review, coupled with other lines of evidence, suggests that interest in incorporating mindfulness into clinical interventions in medicine and psychology is growing. It is thus important that professionals coming to this field understand some of the unique factors associated with the delivery of mindfulness‐based interventions and the potential conceptual and practical pitfalls of not recognizing the features of this broadly unfamiliar landscape. This commentary highlights and contextualizes (1) what exactly mindfulness is, (2) where it came from, (3) how it came to be introduced into medicine and health care, (4) issues of cross‐cultural sensitivity and understanding in the study of meditative practices stemming from other cultures and in applications of them in novel settings, (5) why it is important for people who are teaching mind‐fulness to practice themselves, (6) results from 3 recent studies from the Center for Mindfulness in Medicine, Health Care, and Society not reviewed by Baer but which raise a number of key questions about clinical applicability, study design, and mechanism of action, and (7) current opportunities for professional training and development in mindfulness and its clinical applications.
Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H. Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials.
Objective: To ...systematically review the evidence for MBSR and MBCT.
Method: Systematic searches of Medline, PsycInfo and Embase were performed in October 2010. MBSR, MBCT and Mindfulness Meditation were key words. Only randomized controlled trials (RCT) using the standard MBSR/MBCT programme with a minimum of 33 participants were included.
Results: The search produced 72 articles, of which 21 were included. MBSR improved mental health in 11 studies compared to wait list control or treatment as usual (TAU) and was as efficacious as active control group in three studies. MBCT reduced the risk of depressive relapse in two studies compared to TAU and was equally efficacious to TAU or an active control group in two studies. Overall, studies showed medium effect sizes. Among other limitations are lack of active control group and long‐term follow‐up in several studies.
Conclusion: Evidence supports that MBSR improves mental health and MBCT prevents depressive relapse. Future RCTs should apply optimal design including active treatment for comparison, properly trained instructors and at least one‐year follow‐up. Future research should primarily tackle the question of whether mindfulness itself is a decisive ingredient by controlling against other active control conditions or true treatments.
College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students.
We aimed to test the ...initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption binge drinking, physical activity, and healthy eating fruit and vegetable consumption) and the feasibility and acceptability of the app.
This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.
A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.
Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs.
ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.
Objective
Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional ...mindfulness‐based stress reduction (care as usual CAU + MBSR) versus solely CAU to reduce psychological distress in lung cancer patients and/or their partners.
Methods
We performed a multicentre, parallel‐group, randomized controlled trial. Mindfulness‐based stress reduction is an 8‐week group‐based intervention, including mindfulness practice and teachings on stress. Care as usual included anticancer treatment, medical consultations, and supportive care. The primary outcome was psychological distress. Secondary outcomes included quality of life, caregiver burden, relationship satisfaction, mindfulness skills, self‐compassion, rumination, and posttraumatic stress symptoms. Outcomes were assessed at baseline, post‐intervention, and 3‐month follow‐up. Linear mixed modeling was conducted on an intention‐to‐treat sample. Moderation (gender, disease stage, baseline distress, participation with/without partner) and mediation analyses were performed.
Results
A total of 31 patients and 21 partners were randomized to CAU + MBSR and 32 patients and 23 partners to CAU. After CAU + MBSR patients reported significantly less psychological distress (p = .008, d = .69) than after CAU. Baseline distress moderated outcome: those with more distress benefitted most from MBSR. Additionally, after CAU + MBSR patients showed more improvements in quality of life, mindfulness skills, self‐compassion, and rumination than after CAU. In partners, no differences were found between groups.
Conclusion
Our findings suggest that psychological distress in lung cancer patients can be effectively treated with MBSR. No effect was found in partners, possibly because they were more focused on patients' well‐being rather than their own.
This article reviews the ways in which mindfulness practices have contributed to cognitive and behavioral treatments for depression and anxiety. Research on mindfulness-based interventions (MBIs) has ...increased rapidly in the past decade. The most common include mindfulness-based stress reduction and mindfulness-based cognitive therapy. MBIs are effective in reducing anxiety and depression symptom severity in a range of individuals. MBIs consistently outperform non-evidence-based treatments and active control conditions, such as health education, relaxation training, and supportive psychotherapy. MBIs also perform comparably with cognitive behavior therapy (CBT). The treatment principles of MBIs for anxiety and depression are compatible with standard CBT.
Improvements in stable, or dispositional, mindfulness are often assumed to accrue from mindfulness training and to account for many of its beneficial effects. However, research examining these ...assumptions has produced mixed findings, and the relation between dispositional mindfulness and mindfulness training is actively debated. A comprehensive meta-analysis was conducted on randomized controlled trials (RCTs) of mindfulness training published from 2003-2014 to investigate whether (a) different self-reported mindfulness scale dimensions change as a result of mindfulness training, (b) key aspects of study design (e.g., control condition type, population type, and intervention type) moderate training-related changes in dispositional mindfulness scale dimensions, and (c) changes in mindfulness scale dimensions are associated with beneficial changes in mental health outcomes. Scales from widely used dispositional mindfulness measures were combined into 5 categories for analysis: Attention, Description, Nonjudgment, Nonreactivity, and Observation. A total of 88 studies (n = 5,787) were included. Changes in scale dimensions of mindfulness from pre to post mindfulness training produced mean difference effect sizes ranging from small to moderate (g = 0.28-0.49). Consistent with the theorized role of improvements in mindfulness in training outcomes, changes in dispositional mindfulness scale dimensions were moderately correlated with beneficial intervention outcomes (r = .27-0.30), except for the Observation dimension (r = .16). Overall, moderation analyses revealed inconsistent results, and limitations of moderator analyses suggest important directions for future research. We discuss how the findings can inform the next generation of mindfulness assessment.
Social Work with Groups
Social work with groups (New York. 1978),
10/2017, Volume:
40, Issue:
4
Journal Article
Peer reviewed
Open access
The delivery of mindfulness-based interventions (MBIs) are increasingly popular across a wide variety of educational, clinical, and community settings for diverse populations and challenges.Most ...MBIs, including the well-known Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy programs, are offered in group formats. MBIs and mindfulness-based practices are also being facilitated in elementary, secondary and post-secondary classroom settings. However, to date, there has been little attention paid to the social group work aspects of offering MBIs to groups of adults and young people.The journal is inviting articles discussing social group work and MBIs, and other mindfulness-based practices/activities for people of all ages in an array of settings. Submissions may reflect the perspectives and experiences of helping and health practitioners, researchers, educators, field instructors, students, and/or agency administrators.
Abstract
Introduction
Previous research shows that insufficient and poor sleep is associated with perceiving more stressors the following day. Sleep may also be associated with daily mindfulness, a ...state in which one is highly aware and focused on the present moment without evaluating or judging that moment. The association between high mindfulness and better sleep is well-established; yet, less is known about the temporal directionality between sleep and mindfulness. This study examined whether nightly sleep predicts next-day mindfulness, and vice versa.
Methods
Participants were 60 middle-aged adults working as a full-time nurse at a cancer hospital (Mage=35.35±11.83). Using ecological momentary assessments for 14 days, we asked participants about their previous night’s sleep upon waking and participants completed the 5-item state Mindful Attention Awareness Scale an average of 3 times/day. Multilevel modeling examined variance at the between- and within-person levels and tested two temporal directions simultaneously: better sleep predicting mindfulness and mindfulness predicting better sleep.
Results
Daily mindfulness, sleep duration, sleep sufficiency, and sleep quality displayed 34%, 85%, 82%, and 85% within-person variation, respectively. At the within-person level, daily mindfulness was greater on days following longer than usual sleep duration (B=0.39hrs or 23min, p<.01) and greater than usual sleep sufficiency (B=0.26, p<.001). The within-person link between sleep sufficiency and mindfulness remained even after controlling for the strong association of workdays with less sleep sufficiency. Conversely, mindfulness was not predictive of sleep outcomes. At the between-person level, participants who had greater sleep sufficiency and higher sleep quality overall reported greater mindfulness. These associations remained after adjusting for sociodemographics, dayshift vs. nightshift, and workdays vs. non-work days.
Conclusion
Sufficient sleep duration and perceived sleep sufficiency may be antecedents of how mindful individuals are the following day. Future analyses will test whether the daily link between sleep and mindfulness contributes to health outcomes.
Support
This work was supported, in part, by the University of South Florida College of Behavioral & Community Sciences Internal Grant Program (PI: Lee, Grant No. 0134930).
Abstract
Introduction
Mindfulness-based training has shown potential in reducing anxious and ruminative thoughts before sleep, and improving sleep quality. However, traditional 8-week programs have ...limited acceptability and uptake. In this study, we aimed to test the effects of a short introductory mindfulness training course on pre-sleep arousal and sleep quality.
Methods
Enrollees in a 4-week Mindfulness Foundation Course were invited to participate in the study and were allocated to one of two groups: intervention (N = 57) and waitlist control (N = 39). 101 participants enrolled in the experiment and 96 completed the protocol (mean(sd) age = 49.5(1.5), 56 female). Participants completed the Pittsburgh Sleep Quality Inventory (PSQI) and the pre-sleep arousal scale (PSAS), and were monitored by actigraphy for a week at baseline and post-intervention. To test the effect of the intervention, outcome variables were subjected to repeated-measures ANCOVA with group as a between-subject variable, and age, gender, and years of education as covariates using intent-to-treat analysis.
Results
PSQI scores improved across both groups (treatment: t56=4.25, p<.001, mean(sd) = 6.93(3.25)); waitlist: t38=3.27, p=.002, mean(sd) = 7.15(3.55)); however, there was no significant interaction between group and time. There was a significant group by time interaction in the cognitive arousal subscale of the PSAS (F1,90=4.71, p=.03), Post-hoc tests revealed a significant decrease in the treatment but not the waitlist group (treatment: t50=3.17, p=.001; waitlist: t30=0.20, p=.84). The decrease in cognitive arousal correlated with the decrease in PSQI scores in the treatment group only (r =.3, p=.007). Finally, a statistically significant interaction favoring the treatment group was also observed in actigraphically measured WASO (F1,82=6.18, p=0.015).
Conclusion
The study suggests that a 4-week introductory mindfulness course has moderate effects on reducing cognitive arousal prior to sleep, and that these effects are correlated with improvements in subjective sleep quality.
Support
This study was funded from a STaR investigator grant (NMRC/STaR/0015/2013) and the National Research Foundation (Singapore) Science of Learning Grant (NRF2016-SOL002-001).
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